{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:13:17Z","timestamp":1784297597979,"version":"3.55.0"},"reference-count":56,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi240750-4\"><jats:title>Importance<\/jats:title><jats:p>Maternal hypertensive disorder in pregnancy (HDP) might affect ocular health in offspring; however, its association with strabismus remains unclear.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240750-5\"><jats:title>Objective<\/jats:title><jats:p>To examine the association of maternal HDP with overall and type-specific strabismus in offspring.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240750-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>In the Jiangsu Birth Cohort study, a population-based study in China, pregnant women were recruited from April 24, 2014, to November 30, 2018. A total of 6195 offspring had maternal HDP diagnosis information, of whom 3078 were excluded due to having no information on ocular alignment or due to having ocular diseases other than strabismus or refractive error. Offspring underwent ocular examinations at 3 years of age, completed May 21, 2022. Data were analyzed from May 28, 2022, through December 15, 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240750-7\"><jats:title>Exposure<\/jats:title><jats:p>Maternal HDP, categorized into hypertension and preeclampsia or with blood pressure (BP) well controlled (systolic BP, &amp;amp;lt;130; diastolic BP, &amp;amp;lt;80 mm Hg) and poorly controlled (systolic BP, \u2265130; diastolic BP, \u226580 mm Hg).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240750-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was the incidence of strabismus in offspring. Poisson generalized linear mixed models were used to estimate the association between maternal HDP and strabismus.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240750-9\"><jats:title>Results<\/jats:title><jats:p>Among the included 3117 children (mean [SD] age, 36.30 [0.74] months; 1629 boys [52.3%]), 143 (4.6%) were exposed to maternal HDP and 368 (11.8%) had strabismus. Offspring exposed to maternal HDP had an 82% increased risk of overall strabismus (relative risk [RR], 1.82 [95% CI, 1.21-2.74]), an 82% increased risk of exophoria (RR, 1.82 [95% CI, 1.11-3.00]), and a 136% increased risk of intermittent exotropia (RR, 2.36 [95% CI, 1.13-4.93]) compared with unexposed offspring. When considering the type of maternal HDP, the risk for all strabismus was high for offspring exposed to preeclampsia (RR, 2.38 [95% CI, 1.39-4.09]) compared with unexposed offspring. When considering the BP control level of maternal HDP, the risk for all strabismus was high for offspring born to mothers with HDP and poorly controlled BP (RR, 2.07 [95% CI, 1.32-3.24]) compared with unexposed offspring.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240750-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>These findings suggest that maternal HDP is associated with an increased risk of offspring strabismus. Early screening of strabismus might be recommended for offspring with maternal HDP. Further exploration of the underlying mechanism of the association between HDP and strabismus is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.23946","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T15:02:36Z","timestamp":1721660556000},"page":"e2423946","source":"Crossref","is-referenced-by-count":9,"title":["Maternal Hypertensive Disorder in Pregnancy and Childhood Strabismus in Offspring"],"prefix":"10.1001","volume":"7","author":[{"given":"Hui","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China"},{"name":"State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China"},{"name":"Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"You","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China"},{"name":"Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China"},{"name":"Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangqian","family":"Jiang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China"},{"name":"Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China"},{"name":"Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Lin","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China"},{"name":"Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China"},{"name":"Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 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